Mitral Valve Repair by Alfieri's Technique Does Not Limit Exercise Tolerance More Than Carpentier's Correction.
From: Department of Thoracic and Cardiovascular Surgery, Arnaud de Villeneuve Hospital, CHU, 34295 Montpellier CX 5, France. jm-frapier@chu-montpellier.fr
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
- Publish Date: Jun 2006
- ISSN: 1010-7940
- Volume: 29
- Issue: 6
- Pages: 1020-5
- Medium: Print
- Language: English
- Citation (JAMA): Frapier Jean-Marc, Sportouch Catherine, Rauzy Valerie, et al. Mitral Valve Repair by Alfieri's Technique Does Not Limit Exercise Tolerance More Than Carpentier's Correction.. Jun 2006;29:1020-5
Abstract
OBJECTIVE: The main goal of this study was to evaluate if the edge-to-edge mitral repair could be a limiting factor for exercise tolerance and to compare these results to those of classical techniques. METHODS: Between 2000 and 2002, 54 consecutive patients were operated on for mitral valve regurgitation (MR). Twenty-five patients were operated with Alfieri’s technique (group A) and 29 patients with Carpentier’s technique (group C). The mean age was 63.9 years in group A and 63.8 years in group C (p = 0.98). After a mean follow-up of 16.2+/-12 months, survivor patients were seen at the outpatient clinic, by the same physician for a clinical evaluation, an echocardiogram at rest and at peak exercise, and received a cardiorespiratory exercise testing with maximal oxygen uptake (VO2 max) recording. RESULTS: Clinical status improved with 0% of the patients in class NYHA III or IV in either group postoperatively versus 77% preoperatively. There was no significant MR in 80% of cases in group A versus 89.6% in group C (p = 0.54). The mean mitral valve area was 2.5 and 2.9 cm2 in groups A and C, respectively (p = 0.018). The mitral gradient at rest was 3.8 and 3.3 mmHg (p = 0.31) and the mitral gradient at peak exercise was 8.5 and 9.7 mmHg (p = 0.22) in groups A and C, respectively. Cardiorespiratory exercise testing showed a mean VO2 max of 73.7+/-15% of normal value in group A versus 79.6+/-13.1% in group C (p = 0.18). CONCLUSION: Alfieri’s technique has the same efficiency on improvement of MR and clinical status than classical repair. Despite a higher restriction of mitral valve area at rest in group A, gradient and mean VO2 max at peak exercise were similar in both groups.
Mesh Headings (Keywords): Aged, Aged, 80 and over, Blood Pressure, Exercise Test, Exercise Tolerance, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mitral Valve Insufficiency, Oxygen Consumption, Reoperation, Stroke Volume, Survival Analysis, Treatment Outcome
Check for Full Text / PubMed Unique Identifier (PMID): 16675255
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